When Is Cyst Removal Recommended for a Scalp Cyst?

A pilar cyst, also called a trichilemmal cyst, is a lump that develops from a hair follicle and commonly occurs on the scalp. Some remain quiet for a long time. Removal may be discussed when the lump is tender, gets knocked, makes brushing difficult, or has become a repeated source of inflammation. The clinician examines its surface, firmness, mobility, and surrounding skin before recommending a procedure. A rapidly changing or unusual scalp lump should not be assumed to be a cyst without assessment.

Book an examination if the lump is new, changing, or difficult to see through the hair. Do not try to pop or cut it, as the scalp can bleed and the contents may irritate nearby tissue. Tell the clinician about previous episodes, treatments, medicines affecting bleeding, allergies, and any history of thick scars. Follow hair-washing and dressing instructions after removal, and avoid scratching the healing area. Ask when combing, washing, exercise, or hair appointments can resume.

Get prompt medical advice if the scalp lump becomes suddenly painful, red, hot, swollen, or starts draining, especially with fever or feeling unwell. Seek assessment for bleeding without clear injury, a persistent open area, or a lump that grows quickly. After removal, worsening swelling, spreading redness, continued bleeding, pus, or increasing pain needs review.

Ask: Does this have the features of a pilar cyst? Why remove it now rather than observe it? Will the cyst wall be addressed? Where will the incision be placed, and how might hair and the scar look during healing? When can I wash and comb normally?